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Therapist-Guided Home Stroke Rehab System in Works

Stroke rehab objects

Personalized 3-D printed stroke rehab exercise objects (Virginia Tech)

25 Nov. 2020. A university lab is designing a system that allows for people with stroke to perform rehabilitation at home, while still guided remotely by a therapist. The Semi-Automated Rehabilitation At Home, or Sarah, system is being developed by a team at Virginia Tech in Blacksburg, funded by a four-year $1.1 million grant from National Science Foundation.

Stroke occurs when blood flow to the brain is interrupted, cutting the oxygen needed by brain cells to function. The vast majority (85%) of strokes are caused by blood clots, while many other strokes are caused by blood vessel leakage in the brain. Recovery, often in rehabilitation clinics, can take months or years of continuous exercises. World Stroke Organization says one in four people worldwide will have a stroke in their lifetime, with nearly 14 million people suffering a stroke each year.

The VTC Smart Rehab Lab at Virginia Tech is designing and building the Sarah system. The lab is an interdisciplinary group bringing together researchers from Virginia Tech’s medical and engineering schools seeking a home-based solution for the time-consuming, long-term rehabilitation faced by people with stroke. In most cases today, rehabilitation requires intensive and expensive one-on-one coaching from a rehab specialist. And, say the researchers, telemedicine with today’s technology cannot provide the in-person interactions between rehab specialist and patient required for meaningful progress to occur.

The Sarah system is built around telemedicine, but adds sensing and monitoring tools to routinely and unobtrusively collect data from the patient about their daily exercises, and general life at home for the therapist. The system is called semi-automated because the therapist still directs and manages the patient’s rehabilitation, just not in the same physical location.

Thanassis Rikakis, a biomedical engineering professor — also professor of music — at Virginia Tech and principal investigator on the project says in a university statement, “The main goal here is that we want to be able to provide much more therapy to many more people at a significantly reduced cost.”

The researchers are using inexpensive and easily deployed technologies for the home. The first Sarah version focuses on exercises for the upper torso, with two video cameras recording the patient’s exercise routines. Exercises are personalized and use 3-D printed plastic weights and objects designed specifically for the patient. And the system has sensors worn on the wrists and fingers, like rings, to record the patient’s activity during the day. Sarah provides real-time feedback to the patient while performing the exercises, and also prepares a summary report to enable the therapist to monitor progress and change the rehab exercises if needed.

Virginia Tech is located in the southwest corner of the state, where many nearby rural counties lack high-speed Internet connections. The campus wireless technologies lab is helping design Sarah to operate over regular cellular networks in the region served by university’s medical center.

In addition, researchers are preparing algorithms to help therapists assess patients’ progress with Sarah. The algorithms use statistical models emulating a therapist’s decision-making process that incorporate data collected with Sarah. Data collected from Sarah systems are expected to contribute to a richer understanding of stroke rehab, as well as provide valuable databases for future machine learning algorithms.

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